THE biggest hospital in the country has had to sacrifice scarce public beds because of new arrangements put in place for hospital consultants.
St James's Hospital in Dublin confirmed it had to convert four public beds to private beds in order to provide more accommodation for people with health insurance who are under the care of a consultant.
The change became necessary after the consultant, who was originally hired to treat public patients only, secured a change in his contract allowing him to also admit fee-paying private patients.
Documents obtained by the Irish Independent reveal how the hospital is finding it more difficult to cope with the increased demand for private beds from consultants entitled to treat fee-paying patients.
The demands for private beds were "unsustainable", according to the minutes of a board meeting released under Freedom of Information rules.
It has had to apply to the Department of Health to re-designate a number of public beds as private.
The overcrowded hospital is also under daily pressure to secure a place for patients who come through its emergency department and need to be admitted to a public bed. The loss of the beds is expected to have the most impact on public patients who are on waiting lists and need to be admitted to the hospital for a procedure.
A spokesman for the hospital insisted if a public patient in the emergency department has to be admitted they get the next available bed, whether it is public or private.
Other hospitals are also under strain to provide more private beds for consultants who want to admit fee-paying patients.
Recent figures showed that 50 consultants have applied to switch to 'Type B' contracts, which would allow them to treat both public and private patients.
Although they receive a lower salary, their work is more lucrative because they are able to claim fees from private health insurance companies.
This means that the hospitals they work in are obliged to ensure they have access to private beds for their patients.
A hospital consultant who converts from a public-only contract can devote 20pc of his or her workload to private patients.
Private patients create an income for hospitals and several have increased the number of insured people they treat as their budgets from the HSE have been cut.
A total of 3,002 consultants received payments totalling €25.8m from the VHI last year – an average of €86,000 each.
The Health Service Executive said that under regulations going back to 1991, each region can apply to the Department of Health to increase the number of private beds in their hospitals.